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Hypernatraemia in the first few days: is the incidence rising?
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  • Published on:
    Weighing of breast fed babies is important

    Dear Editor, We read with interest the article by Laing and Wong [1] which highlights the risk of Hyernatraemic dehydration in breast fed babies.

    Undoubtedly, hypernatraemic dehydration is a potentially devastating condition associated with risk of cerebral edema, gangrene, hydrocephalus, intracranial haemorrhage and death.[2] Recently, there has been an increase in the number of cases that are reported [3] and b...

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    Conflict of Interest:
    None declared.
  • Published on:
    Weighing alone will not prevent hypernatraemic dehydration.
    • David Harding, Lecturer, neonatal Medicine
    • Other Contributors:
      • Jacky Moxham, Clinical Risk Manager and Pamela Cairns, Consultant Neonatologist

    Dear Editor

    Having recently reviewed the case notes of babies readmitted to hospital in the first 10 days of life (over a 1 year period), we firmly agree with the views expressed by Laing and Wong.[1] The incidence of documented hypernatraemic dehydration secondary to the failure of lactation in Bristol is 1.7 per 1000 live births much higher than that described by Oddie et al. [2] in the Northern Region (2.5...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypernatraemic dehydration - excess sodium is not the cause

    Dear Editor

    I am grateful to Laing and Wong for raising once again the issue of hypernatraemic dehydration in the first few days of life.[1] However, I think it is important to remember that hypernatraemic dehydration, like anaemia, is a sign of disease not a diagnosis in itself. A low haemoglobin concentration in blood can be caused by a large number of different pathological and physiological processes. Hypern...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypernatremic dehydration

    Dear Editor

    I have read the recent lead article in the Archives, Laing and Wong.[1] I wish to point out that dehydration in the first few days does not occur in breastfed babies. If the babies were breastfeeding, they wouldn't get dehydrated. It occurs in babies who are only pretending to breastfeed. But unfortunately, this is altogether too common, babies leaving hospital only pretending to breastfeed.

    The...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypernatraemia in the first few days: is the incidence rising?

    Dear Editor

    As Laing and Wong [1] correctly state, there is increasing recognition of the occurrence of hypernatraemic dehydration in breast fed babies. However there continues to be confusion regarding the best way to manage this life-threatening problem. The disagreement centres on whether the deficit of free water should be replaced with an isotonic solution (0.9% saline) or a hypotonic one.

    Hype...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypernatraemia in breastfed infants

    Dear Editor

    I congratulate Laing and Wong for a thorough review of the literature on hypernatraemic dehydration in breastfed infant.[1] Their appreciation of the importance of supporting breastfeeding as a way of avoiding this very uncommon problem is most welcome. I entirely agree that simply to promote breastfeeding is not enough, practical support must be made available to women to ensure that problems with in...

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    Conflict of Interest:
    None declared.
  • Published on:
    Hypernatraemia in the first few days: a tragic case.
    • Peter D Macdonald, Consultant Neonatal Paediatrician
    • Other Contributors:
      • Louise Grant, Peter D Macdonald, Samantha RM Ross

    Dear Editor

    Laing and Wong [1] highlight the fact that hypernatraemic dehydration can be difficult to recognise and may have serious consequences. We describe an extreme case.

    An 8-day-old infant was admitted to hospital with a small haematemesis. She had lost 19% of her birth weight and her plasma sodium was 173 mmol/l. She had renal and hepatic impairment and was found to have a thrombosis of th...

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    Conflict of Interest:
    None declared.